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目的观察不同手术方式对先天性上斜肌麻痹的治疗效果。方法对我院收治的52例(59眼)先天性上斜肌麻痹的手术方式和疗效作回顾性分析。结果52例(59眼)中11例(13眼)施行了下斜肌断腱术,23例(26眼)施行了下斜肌后徙术,18例(20眼)施行了下斜肌后徙前转位术。18例(20眼)治愈,23例(28眼)好转,总有效率78.85%(41例)。下斜肌断腱术有效率81.82%,下斜肌后徙术有效率78.26%,下斜肌后徙前转位术有效率77.78%。结论上斜≤15Δ可采用下斜肌断腱术或下斜肌后徙术,下斜肌断腱术与下斜肌后徙术具有同样的矫正效果。上斜16Δ~25Δ可采用下斜肌后徙并前转位术,上斜≥25Δ可采用下斜肌后徙并前转位联合配偶肌(对侧眼下直肌)后徙术。
Objective To observe the effect of different surgical methods on congenital superior oblique paralysis. Methods 52 cases (59 eyes) of congenital superior oblique paralysis treated in our hospital were retrospectively analyzed. Results In 52 cases (59 eyes), 11 cases (13 eyes) underwent oblique tendon surgery, and 23 cases (26 eyes) underwent oblique angioplasty and 18 cases (20 eyes) underwent oblique posterior oblique Migration before transposition surgery. 18 cases (20 eyes) cured, 23 cases (28 eyes) improved, the total effective rate was 78.85% (41 cases). Oblique oblique tendon surgery efficiency 81.82%, inferior oblique reimplant surgery effective rate 78.26%, inferior oblique rectum migration anterior operative efficiency of 77.78%. Conclusion Upper oblique ≤15Δ can be used under the oblique tendon surgery or inferior oblique muscle resettlement, lower oblique muscle tendon surgery and inferior oblique muscle posterior correction with the same effect. Upper oblique 16Δ ~ 25Δ can be used after the inferior oblique muscle migration and anterior rotation, upper oblique ≥ 25Δ can be used after the inferior oblique muscle migration and anterior combined with the spleen (contralateral eye rectus) after migration surgery.